Management of Acquired Tracheoesophageal Fistula in Adults

Abstract

Tracheoesophageal fistula (TEF) is a pathological connection between the trachea and the esophagus that is associated with various underlying conditions including malignancies and other benign conditions such as infections, inhalation injuries, and traumatic damage. TEF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists, and thoracic surgeons alike. Although stents have been a cornerstone in the management of TEF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting procedure both art and science. Management of a TEF requires advanced understanding of the airway and digestive tract anatomy, dimensions of the fistula, stent characteristics and types, and the interplay between the esophageal stent and the airway stent if dual stenting procedure is elected. This chapter will cover a review on the most up-to-date data on risk factors, clinical manifestations, diagnostic approaches, management methods, and prognosis. Consequently, this article serves to evaluate current therapeutic strategies and other novel techniques.